Welcome to Physicians’ Research Network (PRN)

Next Year @ PRN

To PRN Members and Friends:

We at PRN want to take a moment to wish you all a healthy and productive 2012!

This past year we moved our monthly meetings to a new venue on Washington Square for easier access, and we are pleased to report that, with your ongoing support, monthly attendance is strong and growing. In addition to our loyal audience of experienced clinicians, we are also reaching out to younger providers to include their needs and to recruit their help with program development. We have listened to your requests for meeting topics, and are planning a challenging and stimulating series of meetings for the coming year. If you have not yet been to a meeting in our new venue please join us for our next scheduled meeting on Tuesday evening February 28, 2012!

Have you seen any of our new online programs? In the past year, in partnership with the Medical Society of the State of New York (MSSNY), we began publishing edited recordings of our live PRN meetings, with CME, which we provide at no cost to the Clinical Education Initiative (CEI) of the NYSDOH AIDS Institute, for online broadcast on their “Physicians’ Research Network Video Channel” at http://www.ceitraining.org/prn-video/
. We hope that these enduring programs serve as a good refresher for attendees of PRN’s live events who wish to review the content, as well as a resource for those who were unable to attend the original event. Either way, viewers of the online PRN programs will be able to get CME credit. This collaboration of PRN & MSSNY with the AIDS Institute will also help expand awareness of PRN’s educational efforts, and help us recruit new members state-wide and beyond.

Since 1990, PRN has met monthly to help busy clinicians master the art and science of HIV medicine, and we hope to see you soon in the New Year!

Best wishes for 2012,
- Jim

James F. Braun, President
Editor-in-Chief @ www.prn.org

HIV-1 Dual Infection: Real or Imagined?

HIV-1 dual infection, coinfection or superinfection, happens and that it may happen rather frequently. Dual infection has identifiable consequences affecting clinical care of patients who already have HIV and are at continued risk of superinfection. To make matters worse, recombination can occur when two distinct viral variants infect the same cell, adding to the genetic diversity of HIV worldwide, and further complicating the development of a preventive vaccine.

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Understanding HIV Tropism

The ability of HIV to bond to different coreceptors for cell entry is known as tropism. After attaching to CD4, HIV must also bind to one of two additional coreceptors. The predominant coreceptor is CCR5, especially early in the course of infection; alternately HIV may be able to bind to CXCR4, either instead of or in addition to CCR5. Viral and host cell factors determine viral tropism and the dynamics of viral attachment prior to cell entry. Tropism has critical implications for HIV care. This article explains tropism and explores how it may influence decisions regarding the use of CCR5 antagonists for disease management.

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Anogenital Human Papillomavirus Coinfection and Associated Neoplasia in HIV-positive Men and Women

The incidence of anal intraepithelial neoplasia (AIN) and anal cancer, caused by human papillomavirus (HPV), is much higher in HIV-positive women and HIV-positive men who have sex with men (MSM) than in the general population, and highly active antiretroviral therapy (HAART) for HIV disease has had little or no impact on this trend. There is a growing need for definitive guidelines to assess for AIN in HIV-positive individuals, and with better treatment options available, it is even more crucial to identify these patients at an earlier stage. New York is the first state to institute recommendations for anal cytology screening in HIV-positive patients.

Selected Endocrine Topics in HIV: Osteoporosis and Adrenal Insufficiency

The care of HIV-infected patients has become increasingly complex. Endocrine problems, such as osteoporosis and AI, have been frequently reported in the HAART era. Additional considerations may be required regarding the etiologies, diagnosis, and treatment compared with the general population. Further research is required to understand the intricacies of these problems in HIV-infected patients in order to provide optimal care.

The Gastrointestinal Tract in HIV-1 Infection: Questions, Answers, and More Questions!

The GI tract is targeted during all stages of HIV disease, and this is especially so during acute and early HIV infection. CD4 cells are preferentially lost from the GI tract within weeks of HIV infection. Despite long-term antiretroviral therapy, CD4+T-cell reconstitution remains deficient in the GI tract in spite of the reconstitution seen in the peripheral blood.

Since 1990, helping busy clinicians master the science and art of caring for people with HIV disease.

Physicians' Research Network

HIV-1 Dual Infection: Real or Imagined?

Understanding HIV Tropism

Anogenital Human Papillomavirus Coinfection and Associated Neoplasia in HIV-positive Men and Women

Selected Endocrine Topics in HIV: Osteoporosis and Adrenal Insufficiency

The Gastrointestinal Tract in HIV-1 Infection: Questions, Answers, and More Questions!